Intestinal infections

Intestinal infections are a group of diseases that combine a single route of transmission of the pathogen of the disease, as well as its localization in the body - the intestine.

The causative agents of intestinal infections can stay outside the intestine for a long time. Getting outside with feces, pathogenic bacteria remain in water or soil and under certain conditions penetrate into the body of a new "master".

Infection usually occurs when you do not use washed vegetables, fruits, berries or defective products or water.

Since the intestine is the main medium for the activity of pathogenic bacteria, the first sign of such diseases is diarrhea, and therefore, the WHO refers all infections of this type to diarrheal diseases.

ICD-10 code

In the international classification of diseases, intestinal infections go under the code A00 - A09. This group of diseases includes amebiasis, typhus (paratyphus), cholera, shogellosis, bacterial poisoning, tuberculosis enteritis, salmonella infections, diseases caused by parasitic protozoa, viruses (influenza with involvement of the gastrointestinal tract is excluded).

Statistics

According to the World Health Organization, intestinal infections annually kill more than two million people worldwide, most of whom are children. Diseases of this group are widespread and in some countries infant mortality from intestinal infection is up to 70% of the total mortality of children under 5 years.

Epidemiology

As already mentioned, intestinal infections spread from patients or carriers of dangerous bacteria to healthy people. The infected person is dangerous from the onset of the disease, as the condition improves, infectivity also decreases, however, in some cases a person can be dangerous for a long time.

During the research it was proved that the isolation of pathogenic bacteria can remain after recovery, which is due to pathological processes in the intestine. When a person ceases to spread the infection, it can only be determined after a bacteriological study.

In the spread of infection, patients with erased forms are of great importance, since such people are not diagnosed and they continue to be in the collective, spreading dangerous bacteria.

Also, young children who do not yet have basic hygienic skills and who suffer from erased forms of intestinal infections, can easily infect the external environment and objects.

A newborn disease is often transmitted from the mother.

Carriers of pathogenic bacteria are rare, however, such people also contribute to the spread of infection.

Of all types of intestinal infections, salmonellosis can be identified, since animals also participate in its spread. Most often, the disease is transmitted from domestic animals (cows, dogs, cats, horses, etc.), as well as from rodents.

The main source of infection are birds, especially waterfowl. Salmonella bacteria are present not only in organs, as in most animals, but also in the shell and the contents of eggs. In this case, birds stay longer carriers of dangerous bacteria, in contrast to animals.

Intestinal infection can occur either singly or in the form of epidemic outbreaks, with the disease can reach a large scale, for example, as in the case of cholera. In the summer-autumn period there is a high level of the majority of intestinal infections, in the winter period the level of viral diarrhea rises.

[1], [2], [3], [4], [5], [6], [7], [8],

Causes of an intestinal infection

Intestinal infections begin to develop when ingested (intestines) pathogens. As already mentioned, the causative agent of the infection can get into the body with the use of contaminated water (from the tap, spring, etc.), as well as with unwashed vegetables, fruits, etc.

Pathogenic microorganisms outside the body actively multiply, especially in warm and humid conditions. The greatest danger in this regard is the products stored outside the refrigerator, especially meat and dairy products.

In summer, intestinal diseases pose a great danger, because in the heat products deteriorate faster, especially meat and fish, and various insects can carry the infection from infected feces. Incubation period of intestinal infection

An incubation period is the period from the moment pathogenic microorganisms enter the intestine until the first symptoms of the disease appear. In other words, this is a latent period of the disease, when the infection has already occurred, but there are no signs of illness.

Gastrointestinal infections most often occur 12 to 36 hours after infection, in some cases, the latent period can last up to 12 days.

There are three main ways of transmission of intestinal infections : through food, water and by household contact.

Most often, intestinal infection is transmitted through foods contaminated with microorganisms or who have undergone insufficient thermal and hygienic treatment. The source of the disease can be both people and animals (large and small cattle, domestic birds, rodents, etc.). From the carrier, the infection can get into milk (dairy products), eggs, fruits, vegetables.

Transmission of the disease through water is less common. Basically, infection occurs when you use poor-quality water. This usually happens as a result of a rupture of water pipes or sewers.

With household contact, the infection can spread from the carrier through dirty hands or various items (towels, toys).

The causative agents of intestinal infections are pathogenic bacteria that enter the environment with feces and contaminate food or water. There are also bacteria that are excreted in the urine or vomit, for example bacteria of foodborne toxic infections or cholera.

The main source of infection is an infected person or a carrier of a pathogenic infection. A bacterium is called almost healthy person, in the organism of which there are pathogenic microorganisms that are released into the external environment.

Usually carriers of an infection are people with weakened immunity, having had an intestinal infection, and also with chronic diseases of the gastrointestinal tract or gallbladder.

Spread infections can and healthy people, in the body of which hit pathogenic microbes, but took root in it and do not cause their "master" harm.

Feces with pathogens can become a source of infection. Quite often, the disease spreads through dirty hands and objects - if the hands of the sick or carrier infection are contaminated with feces, then everything to which it touches becomes a source of contagion. If a healthy person touches infected objects, he can transfer the pathogenic bacteria to food and become infected. Therefore, experts urge to wash their hands as often as possible, especially after visiting the toilet.

Intestinal infections can spread through toys, hand-rails in public transport, basket pens in a supermarket, etc.

[9], [10], [11], [12], [13], [14],

Symptoms of intestinal infection

Symptomatology of intestinal infections depends on the type of pathogen, but there are common signs by which one can understand the cause of poor health: weakness, poor appetite, abdominal pain.

The action of pathogens in the intestine is not immediately apparent, if the bacteria or viruses enter the digestive tract, an "incubation period" takes place, which can last from 10 to 50 hours.

The appearance of the first signs of the disease depends on the activity of pathogenic microflora in the body, on average the first symptoms appear 12 hours after infection.

Minor indisposition in the beginning is replaced by severe pain in the abdomen, vomiting, frequent loose stool. In addition, the temperature rises, chills, increased sweating and other signs of fever, loss of consciousness is possible.

These symptoms indicate a strong intoxication of the body due to the vital activity of pathogenic bacteria, frequent vomiting and loose stools lead to dehydration of the body, which leads to irreversible consequences (impaired kidney function, change in the cardiovascular system).

Intestinal infections in childhood and old age can cause death.

Syndrome of intestinal infection manifests itself in the form of fever, weakness, pallor of the skin (with some infections on the background of high fever), reducing blood pressure, with severe disease, coldness of hands and feet is observed, in children up to a year intoxication can cause neurological disorders.

In addition, diarrhea and vomiting that occur during intestinal infections can lead to dehydration of the body.

Depending on the causative agent of the disease, intestinal infections can raise the temperature (37 ° C and above).

Some infections occur without a rise in temperature (cholera) or with a slight short-term increase (staphylococcus).

Diarrhea almost always accompanies intestinal infections. After infection, diarrhea may appear after several hours (with food poisoning) or days (with bacterial infection).

Some bacteria can be dangerous to human life, therefore, when the first signs of an intestinal disease appear, you should immediately consult a doctor, especially if the stool is heavily watery or with blood impurities.

Acute intestinal infections represent a group of diseases that affect mainly the intestine. The cause of infection are pathogenic bacteria and viruses. In most cases, these diseases are provoked by severe food poisoning, which is accompanied by diarrhea, vomiting, fever, and abdominal pain.

When symptoms of an acute intestinal infection appear, you need to urgently seek medical help and undergo treatment in a hospital.

The course of intestinal infection

Different types of intestinal infections have different symptoms and can proceed differently, for example, rotavirus infections occur in mild form, cause not only loose stools, vomiting, but also cold symptoms; dysentery develops liquid excrements with blood impurities, the disease usually is difficult, with severe pain in the abdomen, with salmonellosis of stool dark green.

But in some cases, the causative agent of infection remains unknown, and doctors indicate in the diagnosis that the etiology of the disease is not established.

Virtually all intestinal infections proceed in the same way, where one period of the disease gradually gives way to another:

• The incubation period is the time from the onset of infection to the time of the onset of the first symptoms, this period depends on the individual characteristics of the organism and can take from several hours to several days. At this stage, the first signs of intestinal infection may be lethargy, rapid fatigue.
• acute period - lasts from 1-2 days to two weeks. This period is characterized by the appearance of diarrhea, abdominal pain, vomiting, fever.

It is worth noting that some people suffer an infection with one major symptom, i.e. Only with vomiting or only with diarrhea, and the disease can also occur with a rise in temperature, and without.

• recovery period - begins after diarrhea, diarrhea and other signs of an acute stage of illness stop. Restoration of the body can take a long time (up to several years) if the treatment was ineffective or completely absent. During this period the organism is especially susceptible to viruses and bacteria, a high probability of repeated infection with intestinal infection or cold. The course of the disease in acute and recovery stage depends on the causative agent of the disease, the number of bacteria or viruses that have entered the body, the state of the person before infection (weakened immunity, concomitant diseases, intestinal microflora disorder, etc.), and also from the timely treatment.

Complications of intestinal infections

If the disease does not have the necessary treatment, then it is possible to develop a shock state caused by dehydration or the products of the vital activity of the pathogenic flora.

In addition, intestinal infections can trigger inflammation in the abdominal cavity, intestinal bleeding, violation of intestinal microflora, heart failure, inflammation of the joints.

Allergy after intestinal infection can result from the reaction of the immune system to bacteria or viruses. Usually this manifests itself in the form of a rash on the skin.

Viral infections can increase intestinal permeability, which increases the risk of developing food allergies in the future.

Also, allergic reactions may appear against the background of taking medications, especially after taking antibiotics.

The recovery period after intestinal infection can take a long time, the digestive system is broken and it takes some time to restore all functions. To help the body are assigned enzyme preparations that improve digestion, prebiotics and probiotics, which contain useful bacteria for normalization of intestinal microflora.

Weakness is one of the symptoms of an intestinal infection. The malaise results from the action of toxins that poison the entire body and can persist for some time after the disappearance of the main symptoms of the disease (vomiting, diarrhea, fever). Usually the recovery period with proper and timely treatment takes several days. Other factors also play an important role, for example, the state of immunity, dysbacteriosis, concomitant diseases, which can prolong the period of recovery of the body after the disease.

Weakness after infection can be associated with prolonged vomiting, diarrhea, and temperature, which deprive the body of important nutrients and disrupt metabolic processes.

Vomiting often occurs with intestinal infections, it develops due to disruption of the digestive tract and poisoning of the body with microbial toxins.

Vomiting appears in the acute period of the disease, as this recovery, this symptom gradually disappears, during the recovery period, as a rule, vomiting does not bother the person.

Re-emergence of a symptom, especially in the face of weakness, fever, diarrhea, may indicate a re-development of the disease or a new infection.

Often such a situation occurs in the hospital, especially young children who do not observe personal hygiene and contact the hospital with other children who are sick with other infections are especially vulnerable.

Pain in the abdomen with intestinal infection is caused by pathogenic microorganisms that have got and actively multiply in the intestine. Depending on the pathogen soreness can be of different intensity and have a different character - aching, spasms, sharp, etc.

After recovery of pain in the abdomen may remain some time, which is associated with the effects of the life of bacteria and the restoration of normal operation of the gastrointestinal tract.

Often the pain is accompanied by a liquid stool (1-2 times a day), which is associated with inadequate digestive system work after the infection, this condition should not cause fear, but if other symptoms (temperature, frequent loose stools, nausea, vomiting) should be consulted with a doctor.

[15], [16],

Diagnosis of intestinal infection

If the intestinal infection is suspected, the doctor first of all determines the time of the onset of the first symptoms, possible risk factors that could provoke the disease (swimming in water, poor quality water, missing food, contact with animals or birds, etc.). Also, concomitant diseases are found that could increase the risk of infection with intestinal infection (alcoholism, HIV, etc.).

Symptoms of intestinal infection are inherent in a number of other diseases, so it is impossible to accurately diagnose and prescribe additional tests (blood, urine, feces, bacussis) to determine the causative agent of the infection and determine an effective course of treatment during initial examination.

Analysis of intestinal infections is necessary to identify the causative agent of the disease and the selection of an antibiotic that can overcome the infection. Usually, without analysis, the treatment of intestinal infections is protracted, since the drug sensitivity of bacteria to antibiotics or other drugs in different patients may differ.

As already mentioned, intestinal diseases can be viral or bacterial in nature, it is difficult to correctly diagnose and prescribe effective treatment.

For this reason, tests are important for intestinal infections.

Microbiological analysis of feces reveals the causative agent of intestinal infection. Such an analysis is also called sowing, it is based on the study of stool under a microscope followed by sowing. Under the microscope, it is not always possible to determine the type of infection, since there may be a small number of bacteria in the sample under study, so a stool specimen is then sown in a special device that maintains the optimum temperature for bacterial growth. At this stage, when the active growth of bacterial colonies begins, microorganisms inhabiting the intestine are identified.

A few days later the sample of pure cultures is again studied under a microscope for the precise detection of pathogenic bacteria.

If pathogens are found in the stool, an analysis is carried out for bacterial sensitivity to antibacterial drugs. At this stage, various groups of antibiotics are introduced into the colony of bacteria and note how quickly and in what quantity the bacteria die after exposure to a particular preparation.

The results of the analysis indicate the causative agent of infection and other bacteria found in the intestine, as well as to what type of antibiotics are susceptible to disease-causing microorganisms.

Analysis by PCR method allows to determine the type of infection by a small fragment of RNA or DNA of pathogenic microorganisms in any liquid produced by the human body. This study can determine both bacterial and viral infections.

The PCR analysis is quantitative and qualitative. In quantitative research, the number of pathogens in feces is detected, with qualitative - they reveal the type of pathogen of infection.

[17], [18], [19], [20], [21], [22], [23]

Differential diagnostics

Differential diagnostics excludes non-symptomatic diseases, which ultimately makes it possible to diagnose one possible disease.

There are various systems, programs that perform differential diagnosis, both complete and partial.

The main, but not exclusive symptom of intestinal infection is diarrhea, it is differential diagnostics that allows you to exclude mistakes and improper treatment.

Before the diagnosis is made, the expert determines the age of the patient, the nature and frequency of bowel movements, vomiting, the intensity of pain, seasonality is also taken into account.

[24], [25], [26], [27], [28], [29],

Prevention of intestinal infection

For the prevention of intestinal infections, experts recommend observing a few simple rules, first of all you should wash your hands with soap as often as possible (after coming home, visiting the toilet, cleaning vegetables or cutting meat, working in the garden or garden, before eating, etc.) .

If you are in places where access to water is difficult, you need to stock yourself with special antibacterial agents (wet wipes, sprays, etc.).

You can not drink water from the tap, from the spring, the river, the street column, etc.

Before consumption you need to wash fruits, vegetables, berries well. When buying melons, watermelons, it is necessary to give preference to whole fruits, harmful, microorganisms rapidly multiply in notched, crumpled, cracked places.

Buy meat, milk and dairy products only in stores. If you bought raw milk in the market you need to boil it.

During the trip, the products should be stored in separate packages.

You can not swim in forbidden places, during swimming it is important not to swallow water.

Do not allow insects to sit or crawl on food, which are the main carriers of dangerous infections.

Quarantine is conducted to prevent further spread of infection among children in children's institutions, employees, etc. Such measures help stop infection with dangerous infections, and quarantine can be introduced within the kindergarten, school, an institution, and also at the state level with the closure of borders not only for the entry or exit of citizens, but also for the import or export of products.

Prognosis of intestinal infection

Early detection of infection, proper therapy promote complete recovery without serious complications. It should be remembered that after the transferred disease, the body's defenses are weakened and it is helpless against viruses and infections, which requires extra precaution (do not overcool, do not subject yourself to nervous upheavals, stresses, etc.).

With severe development of the disease, toxic shock syndrome, pulmonary edema, renal or cardiac failure, DIC syndrome, etc., are possible.

Intestinal infections are the most common diseases in the world, the pathogens are especially dangerous in the summer season, when favorable conditions for the active reproduction of pathogenic microflora develop.

As a rule, the acute period of the disease passes in a few days, subject to proper treatment (abundant drinking, taking enterosorbents and preparations to restore the water-electrolyte balance). It is worth noting that it is impossible to take antiemetic and anti-diarrhea drugs with intestinal infections, as this will stop the cleansing of the organism from pathogenic microorganisms and toxins and lead to even more intoxication.

If after 2-3 days no improvement has occurred, you should seek medical help and undergo a complete examination in case of infection with dangerous infections.

With improper treatment, relapses often occur, and the disease can become chronic, while a person becomes dangerous to others.

Immediate contact with a doctor is necessary when diarrhea occurs in children under one year, with severe vomiting, when a person can not even take a sip of water without an emetic reflex, with a delay in urination, the appearance of blood in the bowel movement, a high temperature that does not decrease when taking antipyretics, if lost consciousness.